One of the most common causes of low back pain for the middle-aged and elderly population is lumbar spinal stenosis (LSS), LSS is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves at the level of the lumbar vertebra. Namely, LSS involves the narrowing of the lower spinal canal and subsequent entrapment of the cauda equina roots by hypertrophy of the osseous and/or soft tissue structures surrounding the lumbar spinal canal. This is usually due to the common occurrence of spinal degeneration that occurs with aging.
LSS is often associated with incapacitating pain in the back and lower extremities, difficulty ambulating, leg paresthesias and weakness. The typical symptom is increased pain in the legs with walking (pseudoclaudication), which can markedly diminish one's activity level. The characteristic syndrome associated with lumbar stenosis is termed neurogenic intermittent claudication.
There are a number of surgical procedures for the treatment of LSS, including lumbar laminectomy and open decompression surgery. Lumbar laminectomy is designed to remove a small portion of the bone over the nerve root and/or disc material from under the nerve root to give the nerve root more space. Laminotomy is a microdecompression procedure in which a part of the lamina is removed to relieve pressure, or to allow access for the surgeon to be able to remove the offending portion of the disc or the bone spur.
From a surgical perspective, minimally invasive techniques are preferable when possible. To this end, the use of catheters is desirable, which can be introduced into body cavities and manipulated to surgically remove certain tissues. Numerous catheters have been designed to perform various surgical functions. However, many challengers exist, particularly for spinal surgical procedures. For example, it is difficult to fit and maneuver catheters within the geometry of the interspinous space and make accurate cuts therein. This could significantly increase the risk of unintentional injury to adjacent areas. This disclosure provides improvements over these prior art technologies.